Fluvoxamine (luvox) may cause decrease in blood sugar; insulin levels may need to be adjusted

Interaction of SSRI antidepressants with
Heart and Blood-Pressure Medications

Interaction of SSRI antidepressants with

Results in

Gigoxin (Lanoxin) and digitoxin (Crystodigin)

Increase in blood levels of digitoxin and potential toxic effects including mental confusion.

Medications for high blood pressure

Levels of beta-blockers including metoprolol (Lopressor) and propranolol (Inderal) also used for angina may increase, leading to excessive heart slowing and ECG
abnormalities. Calcium channel blockers including nifedipine (Procardia) and verapamil (Calan) may also increase, leading to more potent effects on blood pressure.

Medications for abnormal heart rhythms

SSRI may raise the risk of abnormal heart rhythms when combined with drugs to control heart rhythms, such as flecainide (Tambocor), encainide, mexiletine (Mexitil), and propafenone
(Rythmol)

Levels of benzodiazepines may increase.
Excessive drowsiness or confusion.
Lower doses of benzodiazepines may be needed, fluvoxamine (Luvox) has strongest effect, but problems have also been reported with fluoxetine (Prozac).

Clonazepam (Klonopin) and temazepam (Restoril) may be safer than alprazolam (Xanax) and diazepam (Valium).

Buspirone (BuSpar)

May enhance the effects of SSRIs. However, fluoxetine (Prozac) may reduce the effectiveness of BuSpar.
Some patients with obsessive compulsive disorder who received this combination experienced a worsening of symptoms

Lithium

Can either increase or decrease levels. May lead to lithium toxicity at normal lithium levels

L-tryptophan

Can cause agitation, restlessness, and upset stomach as well as the serotonin syndrome

Major tranquilizers (neuroleptics) such as haloperidol (Haldol), perphenazine (Trilafon) and thioridazine (Mellaril)

Blood levels of major tranquilizer may increase leading to increased side
effects.

F

R

Methadone (Dolophine)

Fluvoxamine (Luvox) leads to increase in blood levels.

Mood stabilizers and anticonvulsants

SSRls [particularly fluvoxamine (Luvox) and fluoxetine
(Prozac)] can cause increase in levels of carbamazepine (Tegretol) and phenytoin (Dilantin). The combination of either SSRI with phenytoin can cause phenytoin toxicity.

Fluvoxamine (Luvox) may increase levels of warfarin (Coumadin).
Increased bleeding may result. The increased bleeding can also result without any changes in the prothrombin test (this bleeding test is used to monitor the dose of warfarin).